The neurocircuitry of fear, stress, and anxiety disorders

Lisa M. Shin, Israel Liberzon

Research output: Contribution to journalReview articlepeer-review

1471 Scopus citations

Abstract

Anxiety disorders are a significant problem in the community, and recent neuroimaging research has focused on determining the brain circuits that underlie them. Research on the neurocircuitry of anxiety disorders has its roots in the study of fear circuits in animal models and the study of brain responses to emotional stimuli in healthy humans. We review this research, as well as neuroimaging studies of anxiety disorders. In general, these studies have reported relatively heightened amygdala activation in response to disorder-relevant stimuli in post-traumatic stress disorder, social phobia, and specific phobia. Activation in the insular cortex appears to be heightened in many of the anxiety disorders. Unlike other anxiety disorders, post-traumatic stress disorder is associated with diminished responsivity in the rostral anterior cingulate cortex and adjacent ventral medial prefrontal cortex. Additional research will be needed to (1) clarify the exact role of each component of the fear circuitry in the anxiety disorders, (2) determine whether functional abnormalities identified in the anxiety disorders represent acquired signs of the disorders or vulnerability factors that increase the risk of developing them, (3) link the findings of functional neuroimaging studies with those of neurochemistry studies, and (4) use functional neuroimaging to predict treatment response and assess treatment-related changes in brain function.

Original languageEnglish (US)
Pages (from-to)169-191
Number of pages23
JournalNeuropsychopharmacology
Volume35
Issue number1
DOIs
StatePublished - Jan 2010

Keywords

  • Amygdala
  • Anterior cingulate
  • FMRI
  • Hippocampus
  • Insula
  • PET

ASJC Scopus subject areas

  • Pharmacology
  • Psychiatry and Mental health

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